Laserfiche WebLink
! <br />I <br />I <br /> <br />AFFIDAVIT CERTIFYING ANNUAL NON INTOXICATING MALT LIQUOR SALES OF <br /> LESS THAN $10,000 ON-SALE ($20,000 OFF-SALE) <br /> <br />As the licensee for <br /> <br />(Name of Establiffhment) <br /> <br />(Address of Establishment) <br /> <br />,ac,o' 3 <br /> <br />I hereby state that the 3.2% beer sales were less than $10,000 for the preceding year <br />($20,000 Off-Sale). <br /> <br />I 1. That the named licensee's fiscal year last ended prior to this statement began <br /> -'] -- ! ~ ,199~'~/''. and ended ~ --.,~ ~-- ,199_~..,c'' <br /> <br />That during that fiscal year, non intoxicating malt liquor sales (3.2% beer sales), <br />whether collected for or not, totaled $ ¥3 ~ ~ <br /> <br />That during that same fiscal year, purchases of non intoxicating malt liquor <br />(whether paid for or not during that fiscal year) totaled $ ,/_.~z~ O <br /> <br /> (In divid u a I~;~i'w~er) -(Partners~il~)' i Corporation) <br /> <br />Title <br /> <br />Subscribed and sworn to before me this <br /> <br />__ day of 1996. <br /> <br />Notary Public <br /> <br /> <br />